Focus Areas

In the first two years, it is aimed that the resident doctor will spend 3 months at the Hearing and Speech Center of Iceland, where they will receive training in audiology, and that a 6-month rotation period (which can be divided into two 3-month periods) will be completed in departments within LSH that have been recognized by the education council, while the remaining 15 months will be spent in the ENT department.

In the subsequent three years, emphasis is placed on increased responsibility in accordance with the objectives, as well as on teaching younger residents and students, along with increased independence in the operating room, although always under the supervision and responsibility of the department's specialists.

The main tasks of the resident doctor involve work in outpatient clinics, emergency outpatient clinics, the operating room, and inpatient wards. Additionally, residents provide consultations for other departments of the hospital and external healthcare institutions with the support of the on-call specialist, as well as shift work.

In accordance with the growing abilities and competencies of the resident doctor, more opportunities will arise as the residency progresses to work with increasing independence. It is important for the resident to know the limits of their abilities and knowledge and to learn when to seek further guidance and expertise when appropriate.

Educational Structure

The theoretical part of the training is based on the book Otorhinolaryngology, Head & Neck Surgery by W. Arnold and U. Ganzer, Springer, 2010. Weekly, a review of material from the textbook is planned, along with an additional hour for case-based teaching. The aim is to cover one subsection from the textbook in each teaching session, but since many sections are lengthy, they will need to be spread over several teaching sessions. This way, the textbook will be utilized for the majority of the residency by each resident.

The resident is then encouraged to regularly read the following journals with review articles in the field, as well as to keep up with the main journals in the discipline:

• Otolaryngologic Clinics of North America

• Current Opinion in Otolaryngology Head and Neck Surgery

• Operative Techniques in Otolaryngology

Courses and teaching will be determined by the education council in collaboration with the chief physician of the resident doctors at Landspítali and the continuing education council for physicians in Iceland. It is expected that the resident will take the opportunity to attend both foreign and domestic conferences to enhance their knowledge. It is recommended that the resident attend educational conferences organized by the European Association of Young ENT Surgeons, which are held regularly. The conference is dedicated to updated guidelines for the treatment of major ear, nose, and throat issues from the European Association of Otorhinolaryngologists. The education is based on case-based teaching and is intended as part of the preparation for the specialist exam of the European ENT Association, which the resident must undertake for their specialist certification.

Research

It is desirable for the resident to engage in research within the department during their residency. The aim is for at least one research project or quality project. The residency supervisor and education director can provide guidance and assistance to the resident. It is desirable for the results of these studies to be published in peer-reviewed journals and/or presented at conferences domestically or internationally.

Progress

The resident is responsible for monitoring their educational progress in practical training and for seeking opportunities to fulfill their educational plan and meet the requirements of the logbook for the completion of the residency.

Educational Plan

Each resident creates a personal educational plan in consultation with their residency supervisor and education director. The resident is responsible for their own education and ensuring that all records according to the objectives and decision-making tools are accessible during the annual progress assessment. The resident will keep track of their own training with an overview of the number of surgeries and other educational opportunities they have utilized, so that a comprehensive picture of the residency's content can be formed in decisions about progress.

Progress Assessment and Evaluation Forms

A logbook will be used to record the progress of the training and to monitor the educational goals of the resident. The logbook is from the European ENT Association and is used as the basis for the examination rights in the association's specialist exam. The resident's performance will be regularly assessed, and feedback will be provided using evaluation forms, such as mini-CEX (mini-Clinical Evaluation Exercise), DOPS (Direct Observation of Procedural Skills), and CbD (Case-based Discussion). A more comprehensive interdisciplinary assessment is a 360° evaluation or so-called holistic assessment (by specialists and other colleagues) of the resident, where clinical skills, knowledge, and the resident's ability and competence in communication with patients, relatives, and colleagues are reviewed.

Annual progress assessment (ARCP) is conducted with reference to the Gold Book. The resident will take decision-making tools, evaluation forms, and a list of procedures, along with the residency supervisor submitting an ESR (educational supervisor report) to the education director and education council.

Supervision

Each resident has a residency supervisor who has received training in supervision. Feedback is given regularly, and educational assessment elements, progress in the logbook, and evaluation forms are reviewed.

Annual progress assessment (ARCP) is then conducted at the end of each year, where the resident and supervisor review logbooks, educational progress, and evaluation forms (see below) are finalized, and the resident's status in the training is assessed. The residency supervisor submits the ESR. However, shorter meetings will be held quarterly in between to keep track of the aforementioned elements.

Specialist Certification

When the resident reaches the final year of their residency, they are required to take the specialist exam of the European Association of Otorhinolaryngologists. This consists of a two-stage exam where the resident first undergoes a written exam, and if they pass, they will proceed to the oral exam. It is the responsibility of the resident to register for the exam and to ensure that they meet all the requirements for taking the exam. One of the conditions for taking the exam is to have completed the logbook of the association, which will be worked on during the residency here in Iceland.

The resident will have their specialist rights recognized when they have passed the exam and met the requirements according to this objective, as well as completed at least 5 years of practical specialized training under supervision.